Did you ever ask your aging parents how many prescriptions they are taking?
The answer could surprise you. Sometimes there are so many pill bottles, no one is keeping track of all of them. Parents’ memory loss, too many drugs to track easily, lack of money to pay for them and other factors can mess up the best of medical intentions when prescriptions are written.
When I worked as a visiting nurse many years ago, it was not uncommon for me to go into an elder’s home and find shoeboxes of pill bottles, some duplicates for the same drug, with different doctors prescribing them. Some of the medications were incompatible with each other. My job was to notify the various MD’s of the problem and instruct the aging person what to stop taking and what to keep taking. The problem, sometimes called “polypharmacy” still persists.
Doctors are often in a hurry and seniors may be too intimidated to insist that their list of medications be reviewed. Worse yet, when various medications are available to treat a particular condition, the drug representatives have visited the doctors’ offices and offered free samples of the most expensive ones. Those may not the only choice and they are not what the elder can afford, but those expensive items may be what are most often prescribed.
What’s the answer to this?
We think an underutilized resource is the neighborhood pharmacist. It may be someone from a chain drug store or from any other kind of pharmacy, but the pharmacist, unlike the MD, will take the time to compare medications. The pharmacist can offer suggestions as to less expensive alternatives and brands. It’s their role to explain what the medication does, explain the side effects and help the person understand the importance of taking what is ordered.
“The pharmacist can be the patient’s advocate with the MD” says Susan Gordon, licensed Pharmacist for 15 years with CVS in Tampa, Florida. “The pharmacist can give the elder or adult child advice about less expensive options the MD does not know about. The MD may not know what it costs to fill the prescription he/she has just given to the senior.”
The Medicare drug benefit is limited and many medications are not covered. Elders like my 89 year old mother in law, Alice, have to pay a lot out of pocket each year for drugs they need to take. For our aging parents on fixed incomes, expensive medications are not in the budget. If we encourage them to find one reliable source of information about what affordable alternatives are available, there is a better chance that they will take what is prescribed for them.
Even though elders may like to shop around for the best drug prices, the advantage of a “home pharmacy” can be the prevention of filling duplicate prescriptions for the same drugs. It can also be an ed
I encourage the use of one place for storing data about all our parents’ prescriptions, where the pharmacist can be a reassuring source of information about not only what elders must pay for out of pocket, but side effects, drug incompatibilities and prescriptions for the same condition from different doctors they see. Says Pharmacist Gordon, “With a home pharmacy, the patient can ask about all the meds they are taking, regardless of where they got the prescriptions filled”.
An alarming number of hospitalizations are related to failure to take medications as prescribed or taking medications incorrectly. Though our aging parents are already a responsibility for their adult children who are involved in their lives, it is reasonable to ask them about their pills and where they get them, especially as they start to show signs of declining health.
I work with many adult children who tell me that their aging parents won’t take medications their doctors have ordered even if they can afford them. Whether they take the prescribed meds or not is the parents’ choice and no one can force them. Anyone has the right to decline treatment. But, we can encourage, support and try to make it easier for aging parents to comply with what the doctors want them to do to treat their conditions. We do so in the hope of enhancing their quality of life.
Our respectfully watching over their medication regime and encouraging the use of one place for getting their prescriptions filled can literally be a life saver.
Until next time,